Reingardiene Dagmara
Clinic of Intensive Care, Kaunas University of Medicine, Eiveniu 2, Kaunas, Lithuania.
Medicina (Kaunas). 2007;43(7):587-93.
Beta-adrenergic receptor blocking drugs are used in the treatment of hypertension, angina, myocardial infarction, cardiac dysrhythmia, cardiomyopathy, migraine headache, thyrotoxicosis, and glaucoma. beta-adrenergic receptor blocking agents are competitive antagonist at beta(1), beta(2), or both types of adrenergic receptors. Overdoses of beta-adrenergic receptor blockers are uncommon, but are associated with significant morbidity and mortality. This review article discusses the properties of beta-adrenergic receptor blockers, presents the doses of these drugs causing toxicity and doses, after ingestion of which, referral to an emergency department is recommended. Clinical presentation of overdose (the cardiovascular, neurologic manifestations, pulmonary and other complications), diagnosis, and treatment (gastrointestinal decontamination; the usage of atropine, phosphodiesterase inhibitors, glucagon, insulin; indications for cardiac pacing, extracorporeal procedures of drug removal, etc.) are analyzed. In addition, this article focuses on clinical course and prognosis of beta-blocker overdose.
β-肾上腺素能受体阻滞剂用于治疗高血压、心绞痛、心肌梗死、心律失常、心肌病、偏头痛、甲状腺毒症和青光眼。β-肾上腺素能受体阻滞剂是β₁、β₂或两种类型肾上腺素能受体的竞争性拮抗剂。β-肾上腺素能受体阻滞剂过量使用并不常见,但会导致显著的发病率和死亡率。这篇综述文章讨论了β-肾上腺素能受体阻滞剂的特性,给出了这些药物导致中毒的剂量以及摄入后建议转诊至急诊科的剂量。分析了过量使用的临床表现(心血管、神经表现、肺部及其他并发症)、诊断和治疗(胃肠道去污;阿托品、磷酸二酯酶抑制剂、胰高血糖素、胰岛素的使用;心脏起搏指征、体外药物清除程序等)。此外,本文重点关注β-阻滞剂过量使用的临床过程和预后。